Thyroid Cancer

What is thyroid cancer

A malignant tumor of the thyroid gland is a disease that occurs when cells grow abnormally inside the gland. The gland itself is shaped like a butterfly and is located in the front of the neck. It produces hormones that regulate energy consumption, ensuring the normal functioning of the body.

Thyroid cancer is one of the less common types of cancer. The prognosis for those who fall ill with them in most cases is favorable, since it is usually detected in the early stages and responds well to treatment.

There are three forms of thyroid cancer.

• Papillary, which accounts for about 80% of all malignant tumors of the thyroid gland. This tumor arises from follicular cells that produce and store thyroid hormones. It can develop at any age, but most often affects people between 30 and 50 years of age.
• Follicular thyroid cancer also arises from follicular cells. They usually affect people over 50 years of age.
• Medullary – occurs in the C-cells of the thyroid gland, which produce the hormone calcitonin and usually a signal for examination is an increase in the level of calcitonin in the blood. This cancer can also occur due to the presence of certain genetic syndromes.

Causes of thyroid cancer

– Thyroid cancer until the 90s was considered a rare oncological disease. The growth of the disease began to be observed from the 92nd year, especially among residents of the southern regions of Belarus and adjacent regions of the Russian Federation. This is due to the radiation contamination of these territories, primarily with radioactive iodine after the disaster at the Chernobyl nuclear power plant, – comments Dina Sakaeva, Deputy Head Physician for Oncology, Professor of the Department of Pharmacology with a course in clinical pharmacology, Doctor of Medical Sciences.

New cells are constantly being formed in the human body, which replace old and damaged ones. When the division process is disturbed, a tumor is formed – benign (adenoma) or malignant – cancer.

Reasons include:

• radiation therapy (prolonged exposure to x-rays can cause a tumor to appear decades later);
• inadequate intake of foods containing iodine;
• family predisposition;
• professional reasons – work with heavy metals;
• stressful situations;
• bad habits.

Thyroid Cancer Symptoms

The appearance of a small nodule on the thyroid gland is the first sign of thyroid cancer. The nodule is visible under the skin and looks like a slight elevation on one side, over time it becomes more dense and increases in size. A lymph node in the neck may also swell.

In the later stages, when the tumor is already large, there is pain in the neck, difficulty swallowing, a feeling of a lump in the throat, hoarseness, cough, shortness of breath and shortness of breath.

If any of these signs or symptoms appear, you should immediately consult a doctor.

Stages of thyroid cancer

In patients with thyroid cancer, the stage of the disease is finally established only after surgery and a morphological study of the removed preparation.

The stage is set based on 3 parameters: T, N, M.

• T – primary tumor, has categories (Tx, T0, T1, T2, T3, T4a, T4b).
• Tx – primary tumor cannot be assessed;
• T0 – no data on the primary tumor;
• T1 – tumor no more than 2 cm in greatest dimension, limited to the thyroid gland (T1a – no more than 1 cm, limited to the thyroid gland; T1b – more than 1 cm, but not more than 2 cm in greatest dimension, limited to the thyroid gland;
• T2 – Tumor more than 2 cm, but not more than 4 cm in the greatest dimension, is limited to the tissue of the thyroid gland;
• T3 – Tumor more than 4 cm in greatest dimension, limited to thyroid tissue or tumor of any size with minimal extension beyond the thyroid gland (sternothyroid muscle, adjacent soft tissues);
• T4a – Tumor extends beyond the thyroid capsule or invades any of the following structures: subcutaneous soft tissue, larynx, trachea, esophagus, recurrent nerve.
• T4b Tumor invades the prevertebral fascia, mediastinal vessels, or surrounds the internal carotid artery
• N – the presence of damage to the regional lymph nodes of the neck (with possible values ​​of Nx, N0, N1a, N1b) The presence of metastases on the neck in areas of regional metastasis does not equate to metastases to other organs. Regional metastases are removed during the operation as a single block with the thyroid gland, which makes it possible to achieve a complete cure for the disease in most patients. Nx regional lymph nodes cannot be assessed; No metastases in regional lymph nodes; N1a metastases at level VI (pretracheal, paratracheal, including paralaryngeal and Delphian) lymph node; N1b metastases in other lymph nodes of the neck or in the retropharyngeal lymph nodes or in the lymph nodes of the upper mediastinum.
• M – reflects the presence of distant metastases (with possible values ​​of 0 or 1)

Based on the combination of TNM parameters, the stage of the disease is established – I, II, III, IV (with symbols A, B or C).

For differentiated forms of thyroid cancer (papillary cancer, follicular cancer) in patients aged 45 years and older, the following classification was adopted according to the stages of the disease.

• I – a small tumor (up to 2 cm) without metastases, not extending beyond the gland
• II – tumor with T2 symbol without metastases.
• III – T3 tumor without metastases or T1-T3 tumor with regional N1a metastases in the absence of distant metastases.
• IVA – T1-T3 tumor in combination with regional N1b metastases in the absence of distant metastases, or a tumor with the T4a symbol in any N symbol without distant metastases.
• IVB – T4b with any N symbol and no distant metastases.

Accordingly, the presence of distant metastases of thyroid cancer (M1) with any T and N symbols is classified as stage IVC disease.

Treatment of thyroid cancer

– Treatment options depend on the stage of the disease, the general condition of the patient. First of all, it is a surgical treatment, and the organ can be removed completely or part of it. In some cases, enlarged lymph nodes are also removed with the gland.

• Radioiodine therapy is a treatment method that uses large doses of radioactive iodine. Usually, this treatment is done after a complete removal of the thyroid gland in order to destroy the remaining thyroid tissue, as well as possible microscopic areas of cancer that were not removed during the operation. Sometimes radioiodine therapy is used to treat recurrence of thyroid cancer.

• Radiation therapy serves as an alternative if the patient cannot undergo surgery and if there is a high risk of recurrence.
• Chemotherapy not commonly used for thyroid cancer, but sometimes helpful when other methods have failed.
• Targeted or Targeted Therapy uses drugs that attack cancer cells and block signals that stimulate cancer cells to grow and divide. It is used only in patients with stage 4 cancer, the doctor continues.

Diagnostics

“Now diagnostics has improved significantly, which allows using new technologies to detect small tumors and formations in the thyroid gland. To put thyroid cancer, you need to donate blood for tests: for thyroid hormones. The doctor prescribes an ultrasound or CT scan of the thyroid gland, and if tumor nodes are found, a biopsy is done, says the oncologist.

Prevention of thyroid cancer at home

You should avoid iodine deficiency, use seaweed, iodized salt. Frequent x-ray exposure of the head and neck area should be avoided, especially for those at risk. It is important to treat thyroid diseases in time, to undergo preventive examinations in a timely manner. Most familial cases of medullary thyroid cancer can be prevented by genetic blood testing.

Popular questions and answers

Answers Dina Sakaeva, Deputy Head Physician for Oncology, Professor of the Department of Pharmacology with a Course in Clinical Pharmacology, Doctor of Medical Sciences: